Active NPI
Chandler Roof, DDS
- General Practice Dentistry
- Clinton, OK
National Provider Identifier
1487347365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7724
- Practice address
- 10321 N 2274 Rd
Clinton, OK 73601-7521 - Phone
- (580) 323-2884
- NPI assigned
- May 29, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7724 | OK | Primary |
Addresses
Primary practice location
10321 N 2274 Rd
Clinton, OK 73601-7521
Mailing address
525 NW 37TH St
Oklahoma City, OK 73118-7021
Phone (580) 890-9205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7724 | OK | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690070400000",
"number": "1487347365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 NW 37TH ST",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731187021",
"telephone_number": "580-890-9205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10321 N 2274 RD",
"city": "CLINTON",
"state": "OK",
"postal_code": "736017521",
"telephone_number": "580-323-2884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOF",
"first_name": "CHANDLER",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-29",
"last_updated": "2023-07-23",
"certification_date": "2023-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "OK",
"license": "7724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.